Accurate, High Resolution 3D Dosimetry

描述(由申请人提供)：放射物理中心(RPC)最近的一份报告显示，38%的机构在第一次尝试时未能通过头颈部调强放射治疗模体认证测试。确定了导致失败的各种原因。该报告提供的证据表明，调强放射治疗的实施不是微不足道的，而且容易出错，患者的治疗可能因此受到影响。一个真正实用的3D剂量测量系统将通过在调试和例行质量保证过程中进行全面的剂量测量验证来解决这些失败的根本原因。这项建议将进一步开发临床上可行的3D剂量测量系统，并在患者队列中首次对调强放射治疗中剂量测量的准确性进行全面的3D调查。我们先前的研究已经证明，一种新的Preage/光学-CT系统可以进行准确和高分辨率的3D剂量测量，并且与其他方法相比具有关键的优势。其中包括更高的精确度、更低的噪声、消除主要伪影来源(散射和边缘效应)以及改进的实用性(对实验室/临床环境的稳健性、稳定性、可加工性等)。这些优势使Presage/光学-CT系统成为未来可行的3D剂量测量系统。我们建议一个强大的三方联盟来追求两个主要目标：持续的技术和研究目标，以及新的临床应用目标。该联盟将3D剂量测量方面的杰出专业知识(Duke)与认证经验(RPC)和材料专业知识(Rider)结合在一起。这些目标平衡了研究创新，以促进非专业临床的3D剂量测量，同时仍然满足了使用更专业的系统进行详细的临床调强放射治疗剂量研究的迫切需要。我们假设新的光学-CT扫描系统和新的辐射变色配方将在不影响精度的情况下实现速度和实用性的大幅提高。我们还假设，与传统的2D技术相比，3D剂量学技术将检测到更多未通过标准比较指标的临床调强放疗分娩。这项提案将在关键临床部位(骨盆、头颈和胸部)的患者队列中首次对调强放射治疗的准确性进行全面的3D调查。成功的完成将提升先进放射治疗验证的最先进水平，并可能证明一种强大而全面的新3D认证技术的可行性，有可能提高临床试验的实践标准。目前迫切需要提高先进放射治疗的准确性。我们研究了一种三维剂量测量系统，它将通过促进剂量误差检测来满足这一需求。将对3D患者治疗中剂量测量的准确性进行首次全面调查。

DESCRIPTION (provided by applicant): A recent report from the Radiological Physics Center (RPC) revealed that 38% of institutions failed the head- and-neck IMRT phantom credentialing test at the first attempt. A wide variety of causes for failure were identified. The report provides evidence that IMRT implementation is non-trivial and prone to error, and that patient treatment may be compromised as a result. A truly practical 3D dosimetry system would address a root cause of these failures, by enabling comprehensive dosimetric verification during commissioning and routine QA. This proposal will further develop a clinically viable 3D dosimetry system and conduct the first comprehensive 3D investigations of the accuracy of dosimetry in IMRT delivery, in patient cohorts. Our prior research has demonstrated that a new PRESAGE/optical-CT system can perform accurate and high- resolution 3D dosimetry, and has critical advantages over alternative approaches. These include substantially greater accuracy, lower noise, elimination of major sources of artifacts (scatter and edge effects), and improved practicality (robustness to lab/clinical environment, stability, machineability etc). These advantages render the PRESAGE/Optical-CT system a viable 3D dosimetry system for the future. We propose a strong 3- party consortium to pursue two major aims; a continued technical and investigational aim, and a new clinical applications aim. The consortium combines outstanding expertise in 3D dosimetry (Duke) with credentialing experience (RPC), and materials expertise (Rider). The aims balance investigating innovations to facilitate 3D dosimetry for the non-specialized clinic, while still addressing the urgent need for detailed clinical IMRT dosimetry studies using a more specialized system. We hypothesize novel optical-CT scanning systems, and novel radiochromic formulations will achieve substantial increase in speed and practicality without compromising accuracy. We also hypothesize that 3D dosimetry techniques will detect more clinical IMRT deliveries failing standard comparison metrics, than conventional 2D techniques. This proposal will conduct the first comprehensive 3D investigations of the accuracy of IMRT deliveries in cohorts of patients in key clinical sites (pelvic, head-and-neck, and thorax). Successful completion will elevate the state-of-the-art for verification of advanced radiation treatments, and may demonstrate the feasibility of a powerful and comprehensive new 3D credentialing technology with potential to elevate the standard of practice in clinical trials. There is an urgent need to improve the accuracy of advanced radiation therapy. We investigate a 3- dimensional dosimetry system that will address this need by facilitating dosimetric error detection. The first comprehensive investigations of the accuracy of dosimetry in patient treatments in 3D will be conducted.